2016–2017 JSSPTA Jaguar Pride Drive
Parent’s Name(s)______
Address______City______State______Zip code______
Phone ______(1)Email Address ______(2)Email Address______
Child’s Name______Teacher ______Room # ______
Child’s Name______Teacher ______Room # ______
Child’s Name______Teacher ______Room # ______
I would like to make the following donation to the 2015-2016 Justice Street School PTA Jaguar Pride Drive:
____ Justice Pride– $1000*
A Justice Pride donation entitles you to:
· Everything included at the Jaguar Pride level PLUS your family will receive an upgraded Hardcover Year Book, Framed Artwork of each of your enrolled children, and your family name on a plaque featured at the school!
____ Jaguar Pride– $500*
A Jaguar Pride donation entitles you to:
· 2016-2017 PTA Membership· 2016-2017 Yearbook (Softcover)
· Kids’ Holiday Gift Shop Coupon · Yearbook Love Lines Entry
· Two (2) Reserved Seats for the Winter Holiday Show· Spirit Wear Coupon
· Two (2) Reserved Seats for the Spring Music Program· Art Show Coupon
· Tickets for Mother/Son Skating or the Mother/Daughter Tea
· Tickets for Father/Daughter Dance or Father/Son Bowling
· 2016-2017 Jaguar Spirit Kit and possibly a few more surprise items!!
____ Student Pride – $250(approximate current cost per student of PTA funded programs)
A Student Pride donation entitles you to:
· 2016-2017 PTA Membership · Spirit Wear Coupon
· 2016-2017 Jaguar Spirit Kit · Kids’ Holiday Gift Shop Coupon
____Other $______(any donation over $250 includes rewards as listed above)
____ PTA Membership - $10 each(Included at each level above)
Joining JSSPTA gives you a voice in your child’s education and entitles you to vote
at PTA meetings.
2016–2017 JSSPTA Jaguar Pride Drive
To learn more about JSSPTA visit us at
Sign up for additional PTA memberships for your family now by enclosing an additional $10 per member with your pledge
# ______Memberships at $10 each Total Membership Fees: $______
Names as they should appear on PTA Membership Cards:
1)______3)______
2)______4)______
Total Amount Pledged: ______
I plan to honor my commitment as follows:
____ Attached is a check payable to JSSPTA for my pledge and/or PTA membership = $______
____ Charge my credit card for the full amount of my pledge and/or PTA membership = $______
____ Charge my credit card in ____ ( 4 or 2 ) installments of $ ______each (Paid in full by May 2017)
Credit card:Visa / MasterCard / AmEx (circle one)
Account #: ______
Expiration Date: ______3-digit security code on the back (4-digit for Amex): ______
Name as it appears on the card:______
Billing Address (if different from above)______Zip______
Authorized Signature:
______
MATCHING GIFT PROGRAM
Ask your employer if they have a matching gift program. Many companies do or can partially fund- find out what your employer does by asking today!
My employer, ______, has a matching gift program and will match this donation in the amount of $______.
For tax purposes of the matching gift program, the Justice Street School PTA Tax ID number is 95-6205050. You will receive an acknowledgment letter upon receipt of your payment that shall serve as evidence of your donation for tax purposes.
*Because the value of the additional benefits for the Jaguar Pride option is approximately $175, part of your donation may not be deductible for tax purposes.Please consult your tax preparer for any tax advice.